Menopause and Perimenopause Functional Medicine Holistic doctor

Functional Medicine Holistic Approach to Menopause and Perimenopause

Dr. Kourtney Sims, MD author Dr. Kourtney Sims, MD
Functional Medicine Doctor
Women’s Health Expert

SymptomsQuality of lifeTreatmentMindset | Stress | Sleep | Diet | Supplements

Menopause is a normal transition all women go through. This however, doesn’t mean you have to be saddled with constant uncomfortable symptoms.

Hot flashes, night sweats, anxiety, depression and other symptoms can have a profound effect on your quality of life. Implementing proper lifestyle modifications can help your body naturally ease into this transition.

In this article, we’ll go over some of the key lifestyle changes and steps you can take to naturally support your body during perimenopause and menopause to ease and even prevent some of the symptoms and discomforts.

What is Menopause?

When you go through puberty, your brain stimulates the ovaries to start producing certain hormones, increasing levels of estrogen and progesterone. As a part of this process, you start your menstrual cycle.

With perimenopause and menopause, the process is happening in reverse. Your ovaries begin to make less and less estrogen and progesterone during perimenopause. This continues until you no longer have a menstrual cycle, called menopause.

This transition takes on average five to seven years. Some women go through the entire process much quicker, while for others, it may take a little longer. When you have had no periods for more than a year, the transition is complete.

Premature Menopause

Menopause is a natural process of the body as fertility declines. When the transition starts before the age of 40, it is considered as premature menopause.

Causes of premature menopause may include:

  • Chemotherapy
  • Certain medications and types of birth control pills
  • Toxins exposure
  • Surgical procedures

Perimenopause & Menopause Symptoms

Perimenopause & Menopause Symptoms

Depending on genetics, lifestyle and other factors unique to you, the transition into menopause you go through may be very different from the one your friends experience.

During perimenopause, most women will notice irregular cycles. Some women experience cycles that get further and further apart, while others may have cycles that actually get closer together.

Many of your body’s cells have estrogen and progesterone receptors, and with less of these hormones being produced, cell function may be affected. As a result, you can feel menopause symptoms throughout the entire body.

Although the experience may be different from one person to another, some of the more common symptoms of perimenopause and menopause include:

  • Hot flashes
  • Night sweats
  • Weight gain
  • Heavier cycle
  • Dry skin
  • Decreased libido
  • Vaginal dryness
  • “Brain fog”
  • Hyperemotionality
  • Mood swings
  • increased susceptibility to anxiety and depression

How Menopause Affect Your Life

As you can see above, some of the perimenopause and menopause symptoms can be very uncomfortable. Having hot flashes multiple times a day for example, can affect your job and personal life. If you’re not getting enough rest due to night sweats, your entire daily routine may be disrupted.

In addition to the physical discomforts, perimenopause and menopause can affect your mental health. You may find yourself aggravated by situations you would normally not react to at all. The emotional filters you used to have seem to no longer exist. This can lead to many conflicts and new issues in your relationships that you have never had to deal with before.

Don’t wait until your cycles are stopped or symptoms get worse

Perimenopause symptoms can surface years ahead of menopause. In many cases, they are treated individually without the awareness that they are being caused by the hormonal shifts of perimenopause.

I see many women in their early 40’s that for the first time ever, experience symptoms such as anxiety and depression. After a quick conversation, we discover that they also have irregular cycles. They are frequently surprised to learn that perimenopause is the root cause behind their symptoms. Since there is a link between female hormones and neurotransmitters or brain chemicals, they experience anxiety, depression and mood swings.

Unfortunately, many of them have already started to take medication for anxiety or depression. In a lot of these cases, these are not only unnecessary, but can also permanently change the brain biochemistry.

The key takeaway: If you notice irregular menstrual cycles, check with your doctor if they might be connected to perimenopause. Always share other symptoms you are having as well. Simple lifestyle changes you can make at this point can ease your transition and may prevent many of the discomforts of menopause. These natural methods tend to work “low and slow”, but over time they can be very powerful. Holistic approaches gently improve your entire physical and emotional health. The earlier you start and take action, the better.

Menopause Treatment: A Holistic Approach

Since menopause is a natural process, we don’t want to halt the transition itself. Instead, the treatment mainly focusses on the discomforts that bother you the most, to improve your quality of life.

It is important to note that just like every woman experiences perimenopause and menopause differently, each woman also needs individualized treatment. The same approach that did wonders for your girlfriend may not be the right one for you. Some women, for example may benefit from hormone replacement therapy, while others do best with non-hormonal natural options.

Below are some of the key guidelines that can naturally support your body in the transition. Ideally, you should work with your doctor and apply these as soon as you can, rather than waiting for more symptoms to appear.

Menopause Transition & Your Mindset: Time to Reflect Within

Perimenopause & Menopause Mindset what's next

In addition to the physical and emotional changes you go through, menopause means that you have to accept the fact that you are no longer in the fertile years of your life.

Biologically speaking, when you go through puberty, your hormones peak so you can reproduce and take care of the next generation. It is a powerful biological function that is imperative for our existence as human beings. With perimenopause, your hormones decline, and your body is no longer capable of reproduction.

Many women struggle with finding a purpose during this time. Perhaps it is time to reflect within, and focus on your personal growth, true self, wants, needs and desires. What else do you want to accomplish in life?

This may go against the natural instinct of women to put the people around them first. You may be used to taking care of other people; when you go through perimenopause, it is time to start taking care of yourself.

Just like the flight safety instructions tell you to put your oxygen mask first before you help others, you will need to learn to put your needs, wants and desires first.

This may also mean that you need to dedicate more time, so you take better care of your health, including maintaining a healthier lifestyle and making better dietary choices to support your body and emotional health during the transition. We’ll cover these next.

Stress & Menopause

Perimenopause & Menopause stress

Speaking of mindset, it is important to pay attention to day to day stressors and how they affect you. When we get stressed, our autonomic nervous system produces cortisol and other hormones. This short-term response is designed to help us survive in life threatening situations. When this happens too soon, however, it can negatively affect the female hormones.

Stress can have many shapes and forms. Sometimes we get used to our day to day stress so much that we are not always aware of it. Whether it is stress due to finances, work, relationship issues, or maybe you just have too many things on your plate, practicing self-care around the area of stress and mindfulness is very important to hormonal management, especially if you are already going through perimenopause or menopause.

Regular exercise, particularly gentle activities such as yoga, meditation, Tai chi, or even walking in nature, can all help you destress and promote a healthy mind-body balance. Make some time for these in your daily routine to help keep your stress under control.

Get Enough Sleep

Get Enough Sleep

We all know how important sleep is to our health and well-being, but did you know that sleep is essential in order for the body to regulate your hormones?

While every person may need a different amount of sleep, six hours of sleep every night is the bare minimum. Some people only need six or seven hours each night; others may need nine to ten.

If you find that you need ten hours of sleep to function your best the next day, make time! Being grumpy or upset the next day because you didn’t sleep enough is not going to help you or the people around you.

In addition to the hours you sleep, the time you go to sleep is also important. Try to be in bed at 10pm so you fall asleep by 10:30pm. The extra light simulation due to staying up late can make your adrenals produce more cortisol which can have a negative effect on your sex hormones. Try to sleep and wake up at the same time each day to help your body get used to this sleep-awake cycle and promote a healthy circadian rhythm.

Menopause Diet

Perimenopause Menopause Diet

Ideally, you should eat a plant-forward diet with mostly natural whole foods. Plant-forward means that the majority of your foods should come from plant sources, especially those that are high in natural phytoestrogens and bioflavonoids.

While every woman may need a different eating plan, here are some of the key components of the diet and foods to eat:

Plant based estrogens

(2-3 times a week)
Best sources include organic non-GMO natural whole soy beans products such as tempeh, miso, and natto that can help to mimic estrogen and minimize some of your symptoms. These foods use the whole soy beans are better options than processed soy products such as tofu or soy milk.
If you have a history of hormone dependent cancer for yourself or in your family, I would focus more on the other groups and skip the soy!

Rainbow vegetables

(5-7 servings a day)
Vegetables are rich in bioflavonoids and phytonutrients that can help modulate your hormones and optimize your gut microbiome. Ideally, 75% of your plate should be veggies.

Animal proteins

(Organic or wild-caught)
If you are eating meat, look for organic grass-fed pasteurized options or wild caught seafood and fish. If you have a limited budget, this is where you want to spend your budget, so you avoid the toxins and chemicals low quality animal foods may have on your health.

Nuts & Seeds

(support heart health)
Estrogen is shown to have a protective effect against cardiovascular disease. Eating a healthy serving of nuts can help support your hearth health when your estrogen levels decrease. Look for high quality fresh nuts and seeds. If you prefer roasted nuts, roast them at home. Heat can oxidize the oils, so consume the nuts shortly after roasting.

Good Omega 3-6 Balance

The standard Western diet is way too high in inflammatory omega 6 fatty acids and is low in the anti-inflammatory omega 3s. Both are essential to health, but it is important to have a healthy balance. Good options to boost your omega 3 intake includes wild caught fish such as salmon, fish oil supplements such as Nordic Naturals or Carlson, and evening primrose oil.

I find that it is easier to focus on healthy foods you can eat, rather than putting too many restrictions.
With that said, it is best to limit processed foods, sugar, and avoid foods you are sensitive to.

Supplements for Menopause

Supplements for Menopause

Depending on the symptoms, your body type, health concerns and other individual factors unique to you, the best supplements for menopause can be very different from one woman to another.

Whether you choose a hormonal therapy or a natural herbal approach, it is always best to consult with a qualified health care practitioner. An experienced provider can help personalize the plan, taking into consideration all your individual factors including your medical history. Herbs for menopause for example, affect more than just the symptoms you want to address. Even with natural therapies, it is important to see the complete health picture and how each herb, vitamin or mineral affects the entire person.

One concern where supplements can help is maintaining bone strength, as estrogen helps maintain bone density. A common occurrence in menopause is bone loss due to the lack of estrogen. Therefore, it is important to make sure you are not deficient in vitamin D and that you are getting enough calcium from your diet:

  • Vitamin D (50-80 ng/mL) (this is optimal level):
    Work with your doctor and test your vitamin D levels, and if needed take vitamin D supplements. Vitamin D deficiency or low levels of the vitamin are very common.
  • Calcium (1200-1500 mg a day)
    Ideally, you should be getting enough calcium from your diet. In case you find this not possible, consider taking calcium supplements so you meet your daily requirements.

Final Thoughts

If you are lucky enough to live into middle-age, do not let menopause slow you down. Use this natural transition as an opportunity to reflect within and focus on your personal growth, true self, wants, needs and desires. Explore all the other things you still want to accomplish in life.

Use this transition as an opportunity to give back to your body. Do not wait until your symptoms become worse. Follow these lifestyle changes as soon as possible to support your health and minimize the likelihood of the associated discomforts and symptoms of menopause

I hope you find this holistic approach to menopause helpful. I wish you the very best success in your journey to better health.

Dr. Kourtney Sims, MD, FACOG, NCMP
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